Prevention of Future Deaths reports · 2019

Peter Lawrence

Regulation 28 report to prevent future deaths, reference 2019-0245, written 1 Jul 2019. A coroner writes one of these when an inquest reveals a risk that could cause further deaths unless something changes.

Date of report1 Jul 2019
Reference2019-0245
DeceasedPeter Lawrence
CoronerZafar Siddique
Coroner areaBlack Country
CategoryMental Health related deaths
Organisation namedDudley and Walsall Mental Health Partnership NHS Trust
Sourcejudiciary.uk record · original PDF
Responses published1

The report

Text extracted from the PDF text layer. Reproduced verbatim, including the scan's own layout.

REGULATION 28:  REPORT TO PREVENT FUTURE DEATHS  

REGULATION 28 REPORT TO PREVENT FUTURE DEATHS 

THIS REPORT IS BEING SENT TO: 

1.  Chief Executive, Walsall Metropolitan Borough Council 

2.  Chief Executive, Dudley and Walsall Mental Health Partnership 

3.  Care Quality Commission- copied in for their information only. 

1 

CORONER 

I am Zafar Siddique, Senior Coroner, for the coroner area of the Black Country. 

2 

CORONER’S LEGAL POWERS 

I make this report under paragraph 7, Schedule 5, of the Coroners and Justice Act 2009 
and regulations 28 and 29 of the Coroners (Investigations) Regulations 2013. 

3 

INVESTIGATION and INQUEST 

On  the  20  February  2019,  I  commenced  an  investigation  into  the  death  of  Mr  Peter 
Lawrence (PL). The investigation concluded at the end of the inquest on 3 June 2019. 
The conclusion of the inquest was an open conclusion. 

The cause of death was:   

1a Total Spinal Cord Transactions 
b Traumatic Fracture And Dislocations Of Vertebral Column 
c Traumatic Bilateral Haemopneumothorax 

4 

CIRCUMSTANCES OF THE DEATH 

i)  Mr  Lawrence  was  a  48  year  old  gentleman  who  had  been  diagnosed  with 

paranoid schizophrenia. 

ii) 

 He had over 19 previous admissions to Psychiatric Hospitals when he was 
detained  under  the  Mental  Health  Act.  His  last  admission  was  at  Dorothy 
Pattison  Hospital  on  the  20  August  2017  to  26  October  2017.  He 
successfully  appealed  against  his  detention  to  the  mental  health  tribunal 
and  was  discharged  from  his  section.  During  periods  of  relapse  he  was 
known to deposit faecal matter in his bath.  

iii)  Attempts  at  follow  up  appointments  were  difficult  and  he  disengaged  from 
the service until 22 January 2018 when a joint home visit with the housing 
officer identified the poor state of his living environment. A care coordinator 
was also involved in trying to support him.  

iv)  On 6 August 2018, he was found in the canal with an apparent attempt to 
self-harm. He was taken into Police custody and recalled to prison with no 

1 

[IL1: PROTECT] 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 mental health act assessment taking place. 

v)  He was released back into the community on 4 October 2018 and attempts 
were made to see him again. However he didn't allow entry to his flat and 
was still difficult to engage and meet.  

vi)  At a joint home visit on the 22 January 2019, with his care coordinator and 
housing officer, it was noted that his flat was filthy with bird faeces and there 
was no electricity or gas.  There was no bed and it appeared he slept on the 
floor with a sheet covered with a blanket.  His bathroom was full of human 
faeces. 

vii)  On the 8 February 2019, the deceased was found on the ground outside his 
flat having fallen from the balcony. He sadly died from the traumatic injuries 
sustained.  

5 

CORONER’S CONCERNS 

During the course of the inquest the evidence revealed matters giving rise to concern. In 
my  opinion  there  is  a  risk  that  future  deaths  will  occur  unless  action  is  taken.  In  the 
circumstances it is my statutory duty to report to you. 

The MATTERS OF CONCERN are as follows.  –  

1.  Evidence  emerged  during  the  inquest  that  a  number  of  contributory  factors 

played a role in his death as highlighted as follows: 

2.  There  was  a  lack  of  a  joint  multi-disciplinary/agency  care  plan  (between  Local 
authority  and  Mental  Health  Trust)  which  could  have  resulted  in  delays  in  a 
timely response to known relapse indicators. 

3.  A  more  assertive  approach  with  consistency  of  care  coordinator  for  a  patient 
with  a  history  of  disengagement  and  relapse  could  possibly  have  been 
implemented  reducing  the  likelihood  of  disengagement  with  services  and 
promoted necessary concordance with medication. 

4.  A  decision  to  admit  to  hospital  under  the  mental  health  act  following  concerns 
being raised about self-care and disengagement could potentially have followed 
a  coordinated  MDT  review  and  mental  health  act  assessment  and  prevented 
deterioration in his mental health. 

5.  When PL was successful at the mental health tribunal and was discharged from 
Section  3  following  his  last  admission  to  hospital  in  October  2017  against  the 
view  of  the  multidisciplinary  team.    The  agencies  involved  placed  too  much 
reliance  on  this  decision  and  follow  up  engagement  and  monitoring  with  PL 
reduced becoming inadequate. 

6 

ACTION SHOULD BE TAKEN 

In my opinion action should be taken to prevent future deaths and I believe you have the 
power to take such action.  

2 

[IL1: PROTECT] 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 1.  Both  agencies  involved  may  wish  to  consider  reviewing  their  approaches  to 
multidisciplinary/agency  care  plans  and  risk  assessments  for  community 
patients with these complex needs. 

7 

YOUR RESPONSE 

You are under a duty to respond to this report within 56 days of the date of this report, 
namely by 27 August 2019. I, the coroner, may extend the period. 

Your response must contain details of action taken or proposed to be taken, setting out 
the timetable for action. Otherwise you must explain why no action is proposed. 

8 

COPIES and PUBLICATION 

I  have  sent  a  copy  of  my  report  to  the  Chief  Coroner  and  to  the  following  Interested 
Persons; Family. 

I am also under a duty to send the Chief Coroner a copy of your response.  

The  Chief  Coroner  may  publish  either  or  both  in  a  complete  or  redacted  or  summary 
form. He may send a copy of this report to any person who he believes may find it useful 
or  of  interest.  You  may  make  representations  to  me,  the  coroner,  at  the  time  of  your 
response, about the release or the publication of your response by the Chief Coroner. 

9 

 1 July 2019                                                

Mr Zafar Siddique
Senior Coroner 
Black Country Area 

3 

[IL1: PROTECT]

Responses

1 response published against this report on judiciary.uk. A response is a body's written reply to the coroner's concerns; publication is at the discretion of the Chief Coroner's office, so an absent response does not mean nobody replied.

Response from Dudley and Walsall Mental Health NHS Trust (PDF)
2nd Floor Trafalgar House 
47-49 King Street 
Dudley 
DY2 8PS 
Tel: 01384 324524 

Email: 

13 September 2019 

Mr Z Siddique 
HM Senior Coroner 
Black Country Coroner’s Court 
Jack Judge House 
Halesowen Street 
Oldbury 
West Midlands 
B69 2AJ 

Dear Mr Siddique 

Ref: Peter Lawrence Inquest 3 June 2019 Regulation 28: Report To Prevent Future Deaths – 
Dudley and Walsall Mental Health Partnership NHS Trust (“The Trust”) Response. 

I write further to the inquest held in relation to Peter Lawrence and your Regulation 28 Report to 
the Trust dated 1 July 2019.  I understand that the confirmed deadline for the Trust’s response is 
Monday 16 September 2019.   

In addition to the work carried out to implement the recommendations arising from the Trust’s RCA 
Investigation Report, upon which you heard oral evidence at the inquest, both the Trust and  
Walsall Council have been working closely together in order to formulate an approach to address 
the concerns contained within your  Regulation 28 Report. 

I would, first of all, like to express my sincere condolences to Peter’s family for their loss and to 
assure them that the Trust working in conjunction with the Local Authority are fully committed to 
providing excellent mental health care to the service users of Dudley and Walsall in a way which is 
safe and effective for patients and their families. 

The Trust has in conjunction with  Walsall Council  formulated a further joint action plan to ensure 
that policies and procedures relating to multidisciplinary/agency care plans and risk assessments 
meet the needs of community patients with complex needs and that a multi- agency working 
approach is reinforced going forward. 

I do hope that the proposed actions detailed in the attached plan address the areas of concern 
outlined within your Regulation 28 Report to the Trust. However should you need any further clarity 
or explanation regarding the same please do not hesitate to contact me. 

Yours sincerely 

Mark Axcell 
Chief Executive Officer

Related reports

Other reports by Zafar Siddique

See all →

More reports categorised “Mental Health related deaths”

See all →

Track Dudley and Walsall Mental Health Partnership NHS Trust

See every Prevention of Future Deaths report matching Dudley and Walsall Mental Health Partnership NHS Trust, and how often a new one appears.

What would an alert for this have sent me? Search the full text

Free to try — the preview shows the real matches and how many arrived in the last 12 months. Your first email alert is free.

These reports are published by the Chief Coroner's office at judiciary.uk and are © Crown copyright. The text here is reproduced from the published PDF so it can be searched. If something on this page is wrong, or you are a person named in it and want it reviewed, email drcjar@gmail.com and we will act promptly.